Sunday, 11 December 2011

Home-based upper limb rehabilitation using a modified Wii system

Study aims

The Wii Stroke Therapy for Arm Rehabilitation (Wii STAR) study (formerly the Upper Limb Rehabilitation study) aims to investigate the possibility of using low cost commercially available components employed in the games market to encourage patients to practice the upper limb movements required for the completion of everyday tasks.

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Why is the project necessary?
Between 55 and 75% of stroke survivors fail to regain functional use of their impaired upper limb. Previous research has shown that a considerable amount of practice is required to achieve an improvement in upper limb ability. However, after discharge from hospital access to sufficient rehabilitation is often difficult to achieve, due to cost, distance and availability of rehabilitation services. Whilst several robotic systems to aid upper limb rehabilitation have been developed, their promise, costs, size and requirement for technical support has resulted in them only being suitable for use in the hospital environment and not for home use.

Findings so far
Harnessing the motivating power of computer games, Nintendo have developed the Wii Fit and several centres have been encouraging patients to use Nintendo's Wii to increase their level of activity. However for most stroke patients the Wiimote is too bulky to hold if their grip is still affected. In conjunction with users, we have been developing a low cost, low maintenance virtual reality system as a method of delivering intensive, task specific upper limb exercises for patients after stroke in their own home prior to a definitive trial. The intervention consists of a virtual glove that enables the capture of the location of the hand, fingers and thumb. In order to play the accompanying games, the user must perform movements that underpin functional activities such as reach to grasp, grasp and release and pronation and supination. The development of the system followed a recognised procedure for the involvement of users.
As a result of feedback from patients and therapists and the emergence of new gaming technology the glove itself has gone through several stages of development to ensure it is robust, easy to put on and wear and that the games are sufficiently motivating to encourage players to repeat the movements at the frequency required to improve their arm function.

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